Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Christopher Charles Fanella

Individual provider Medical Physician Assistant · NPI 1013686914

Christopher Charles Fanella is a Physician Assistant in Miramar, Florida. Qualified in 2021, 5 years ago. Practices with South Florida Spine and Sports Specialists LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2021
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Practice location Address checks out

3000 SW 148th Ave Ste 115
Miramar, FL 33027-4181
Phone: (954) 438-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 9115102 (FL)

Record details

NPI number1013686914
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 13, 2021
Last updated in NPPESOctober 28, 2021
Certification dateOctober 28, 2021
Mailing address3000 Sw 148th Ave Ste 115, Miramar, FL 33027-4181

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice South Florida Spine And Sports Specialists Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Miramar